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Hyaluronic acid, or HLA, is a natural source of PSGAGs (it’s found in connective tissue and synovial fluid).“We’ve had very good luck with HLA,” says James Cook, DVM, director of the Comparative Orthopedic Laboratory at the University of Missouri–Columbia College of Veterinary Medicine. “We do a series of three joint injections, the first with HLA and Depo-Medrol, and the last two with just HLA. It’s been very effective, even in dogs with advanced OA.”

HLA is also given orally, but there’s no evidence that it’s effective that way, says Dr. Boothe.

Other TherapiesRehabilitation.
Physical therapy can be very helpful, says Dr. Caywood.“Strengthening exercises and activities like swimming or using an underwater treadmill build the muscles in and around the joint, making it easier for the dog to get around,” he explains.“Rehab” swimming is done under controlled circumstances, with the dog wearing a safety vest, the water at optimum temperature and constant monitoring. A vet trained in veterinary physical rehabilitation may be able to offer other options as well.

Therapeutic Lasers.
Low-level lasers have been shown to reduce pain and inflammation and to stimulate healing in humans and animals.
Electromedicine.
Extracorporeal shock wave therapy (ESWT) uses powerful, high-energy sound waves to treat OA (it’s painful, so dogs are typically sedated for this treatment). Pulsed signal therapy (PST) delivers small, imperceptible pulses of electromagnetic energy. A handful of studies have shown that both therapies can be effective in animals as well as humans.
Acupuncture and Heat.
Studies suggest that this ancient Chinese treatment can reduce stress, pain and inflammation. “We’ve seen some great results in dogs with arthritis,” says Dr. Gaynor, who is also certified in veterinary acupuncture.Another chi stimulator, far infrared or radiant heat, has been used to reduce discomfort as well.
Regenerative Stem Cell Therapy.
Arthritic dogs can be treated with stem cells harvested from the dog’s own fat stores (cells are harvested, re-engineered, then injected into the arthritic joint). A recent study found that treated dogs had significantly less lameness and pain and better range of motion. The stem cells seem to help regenerate cartilage and other tissue, providing pain relief in the process, says Dr. Gaynor.

Surgery
Arguably the last choice in any menu of treatments, surgery can offer an arthritic dog a chance at real relief. Veterinary surgeons can remove painful bony growths and other problems arthroscopically, and can partially or completely replace a dog’s hip joint, all with generally good results. Total elbow replacement is available as well, although the success rate in elbows isn’t as high as that in hips, says Dr. Caywood. Right now, hips and elbows are the only joints that can be surgically replaced.
Looking Ahead
Canine OA has probably been around as long as canines. The difference now, says Dr. Cook, is that we’re better at recognizing it. And we’re more concerned with treating it than dog owners of the past might have been.

“Now, we’re looking at ways to spot arthritis before it gets too advanced,” he says. Researchers are also looking for genetic biomarkers—factors in the dog’s blood or joint fluid that would show the likelihood of his developing OA in the future. He encourages owners to know their dog’s predisposition for inherited joint diseases (the Orthopedic Foundation for Animals [offa.org] publishes dysplasia statistics for various breeds), then talk to a vet about ways to minimize the OA that might occur. “Anything that you do early in the dog’s life will have much more impact than what you do after the problem has developed,” he says.

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Thin Is In
Research has consistently shown that dogs who are on the skinny side live longer, healthier lives than dogs who are overweight, or even what’s considered “normal” weight. A landmark study published a few years ago tracked a group of Labrador Retrievers from seven different dams and two different sires over their lifetimes. Starting at eight weeks, half of the dogs were fed a standard diet; the others were fed 25 percent less. At age eight, they were x-rayed for arthritis, and the leaner dogs had much less of it: Only about 5 percent of the dogs fed a limited diet, compared to 45 percent of the control group, had arthritis in two or more joints. “We know that a lot of arthritis is preventable just by keeping your dog at an ideal weight,” says Julia Tomlinson, PhD, a Certified Canine Rehabilitation Practitioner and member of the American Association of Rehabilitation Veterinarians in Burnsville, Minn. “At least half the dogs that walk into my rehab clinic are overweight, and most of them come because of a specific problem that’s being exacerbated by their weight.”

“Reading” Your Dog
How do you know if your dog is in pain? Vets and other experts say that certain breeds (including working and hunting dogs) have huge pain tolerances, and the “typical” signs of pain—whining or whimpering; constantly licking a body part; being aloof or clingy, restless or lethargic—are all over the map. But you can “read” your dog’s pain if you know what to look for.

“Typically, dogs who are developing arthritis look a little stiff first thing in the morning, but seem fine after they’ve been up and about for a while,” says Jamie Gaynor, DVM. “Or they’ll look okay unless they overexert themselves, and then they might limp for a bit.”

But not all dogs are typical. “Some dogs let you know pretty quickly when something hurts, but others are incredibly stoic. Also, arthritis pain waxes and wanes, so your dog might do the same thing today that he did last Wednesday, but today, it hurts.”

The bottom line: Keep an eye out for anything that’s unusual. Some dogs get grouchy when they’re hurting, while others seek more affection than they used to. “What’s important is to start picking up on patterns,” says Dr. Gaynor. “Watch the dog to see if he looks stiff at certain times or if he looks worse when it’s rainy or cold, or after you bring him home from the dog park. If you see that over and over, over a period of weeks to months, that’s the signal that a veterinarian really should take a look.”

Martha Schindler Connors writes about health, fitness and nutrition and is a former senior editor at Natural Health. In her free time, she volunteers with Pointer Rescue (pointerrescue.org). martha-connors.com